Thursday 3 November 2016

Quality Rehab With Great Outcomes For Our Clients.

I’ve spent most of the week auditing our records and sorting our outcome statistics. It’s a long-winded business as we are still paper based and dreaming of the day our antiquated IT will be replaced with exciting new systems accessible at the touch of a button.
 
Great Stats for us: Anyway….. I’ve completed the stats and it’s great to see that yet again we’ve made improvements in retention and engagement.
 

  • 98% referred for an alcohol detox completed their withdrawal programme
  • 85% completed Secondary Care (meaning they actually completed 6 months in treatment)

 
These figures don’t include those who decide they had sufficient residential treatment and wanted to conclude their recovery programme in the community.
 
Naïvity of NTA : It’s frustrating to hear that the NTA (National Treatment Agency) considers that residential treatment sector is not achieving positive outcomes compared with structured day care in the community. The NTA make this decision based on the data they receive through National Drug Treatment Monitoring System (NDTMS): data that all services in England are required to complete for each client that enters the treatment system.

What the NTA have naively miscalculated is that NDTMS doesn’t really “fit” the residential sector. The data we are asked to input is flawed – as it doesn’t include some of the untidier aspects of the work we do. For example, how to take into account how physically and mentally unwell clients may be on admission…how we only have a limited period to work with these individuals (compared with the community who may be seeing clients for years)… and the fact that clients are away from their families and friends which can be quite unsettling for some etc. etc. …..
 
Why do commissioners waste public funds?

When our detox is FREE and successful. We can clearly demonstrate that 92% of clients referred to us for a detox successfully completed their withdrawal programme (a stat many a detox ward would love to produce) and our detox programme is actually free of charge. But commissioners continue to prefer to purchase detox using public money from their local hospital or inpatient detox provider.

How daft is that? We are FREE and obviously successful but public money is being spent delivering services that are already being offered as part of a residential programme at no additional charge.

Maybe we should start charging for this service, would that give it extra kudos? If I’m paying for something these days I want best value and best quality, I think I have evidence that we are providing just that.

 



from Western Counselling https://www.westerncounselling.com/blog/addiction-issues/rehab-addiction-issues/client-outcomes/
via Alcohol

Wednesday 26 October 2016

Discrimination Even in Death

When there is a death we mourn the passing, we share our grief and take solace from the comfort offered by others.  However, when addiction is involved the situation changes.  “Oh well, it’s just another dead junkie!”  “One less on our streets!” “No waste there!” These are all comments I have heard and there are more.
 


 
Sadly, when an addict/alcoholic dies all too many families take the decision to limit the truth about the death of their loved one preferring the white lie – “an aneurysm, very sudden!” “A brain tumour, we never knew!” “Heart problems”.  In no other situation that I can think of would we ever lie or minimise the truth about someone’s death. Perhaps in the ‘80’s there was a similar stigma surrounding HIV deaths. But discrimination around drug and alcohol use has reached ridiculous proportions.
 
Discrimination: Headlines scream “junkie”, but why is this considered ok?  Why is it considered appropriate for our national media to use these phrases and make them part of our everyday language?  No other marginalised or vulnerable group would permit it. In fact, we’d all be up in arms, screaming and citing discrimination. We’ve come a long way with rights on LGBT, disability, mental health and ethnic minorities. There may still be a long way to go, but at least action can be taken when these groups suffer abuse of their condition, race, creed, sexuality, even age!
 
When will this same consideration be extended to the bereaved families and friends of an addict? Will they ever be able to hold their heads high and say “ yes, sadly he/she died of an overdose”, “ he or she had been drinking excessively for a long time, it was only a matter of time”, “He/she struggled with addiction for many years, it has been very sad for us all”?
 
There are church services held specifically for families who have been bereaved through addiction. These services give them an opportunity to stand up and speak about addiction.  For many, it’s the first time they can say “In memory of my son/daughter who died from an overdose/drinking too much”.  It’s a release; the chance to be honest about the death and be comforted by others who know only too well the discrimination they’ve faced.
 

 
Why do people, normal hard working, caring individuals consider it acceptable to discriminate in this fashion?  I have friends who, forgetting my situation, have made derogatory remarks about drug and alcohol users.  I try not to judge them and to rise above it. I’ve lived with the disease of addiction and I’ve experienced bereavement as a result of it.   Now I’m proudly standing tall, all 5ft 10’’ of me, and proclaiming my role in helping to reduce discrimination in life.
 
I’m part of a fantastic service that has delivered help, treatment and support to thousands of individuals and their families. We are an important resource. I’m going to be very loud because I am very proud.

from Western Counselling https://www.westerncounselling.com/blog/death-from-addiction/discrimination/
via Alcohol

Friday 14 October 2016

Life Skills in Recovery

We all know that to do well, or even excel in life, we need a variety of skills; from simply learning to communicate with ours peers, to being able to read and write. Or at the other extreme – an in depth knowledge of quantum physics – a skill I most certainly don’t have!

We all need skills for life

But for addicts whose ‘using’ and addictive behavioural patterns began before these skills developed – their long-term recovery is threatened, despite their abstinence. It’s well documented that teen drug/alcohol use arrests development. There’s even research that suggests that alcohol use prior to the full development of the frontal lobe (approx. 19yrs) can seriously affect the brain’s ability to work to maximum effect.

We regularly admit clients to Western Counselling who have very limited social functioning. They have no comprehension of how to socialise without the use of drugs and/or alcohol and hold a belief that they need the drugs and/or alcohol to be likeable. They often have zero work experience because their ‘using’ was funded through the misguided generosity of their family or DWP Benefits.

We believe the purpose and mission of our centre is not only to get clients ‘clean’, but also to give them the tools and skills they will need to become functioning members of the community when they leave us. We aim to give each individual the best chance of success after treatment.

Developing life skills through workshops and study groups

We do this by treating addiction through our 12Step programme and by treating individuals holistically, exploring every aspect of their life, beliefs, and family. We believe this is crucial to a recovery that is all encompassing and long lasting. Through our programme of Life Skills workshops in Primary and Secondary treatment clients have an opportunity to improve literacy, numeracy, learn cookery, basic home economics and money management. And through volunteering opportunities they learn transferable life skills and build their self-esteem.

To give our clients even more opportunity to develop life skills Western Counselling is now working in partnership with Lighthouse, a social action charity in Weston-super-Mare. Their Make a Difference Project gives our clients the opportunity to volunteer in the community to train and learn vital skills. Look out for more about this project in my next blog.

Read more of our articles here



from Western Counselling https://www.westerncounselling.com/blog/recovery-from-addiction/life-skills/
via Alcohol

Tuesday 4 October 2016

Don’t Forget the Family

Addiction is a family illness. It affects everyone who comes into contact with the behaviours.  Many of us who have lived with it are often unaware of the severity of the problem.  Personally, it took me 8 years to realise that the person in my family who was a heavy drinker and liked the pub, was actually an alcoholic.
 


 

I know I’m not alone, I regularly attend Alanon http://www.al-anonuk.org.uk – a support group for those affected by alcoholism – and hear stories of those who have enabled and colluded with their addicted loved one.
They do it in order to hide their own humiliation, embarrassment and/or shame at the situation.  We feel guilt.  What have we done to cause this?  What could we have done to make a difference?  How are we supposed to handle what’s happening?
 

The family are the forgotten ones.  Fortunately, more recently emphasis has been placed on assisting families.  Western Counselling runs a Family Programme to inform, assist and support families and those affected by another’s addictive behaviours.  Through advice and education our programme helps the family understand their role in addiction and recovery.  Family members need to realise and admit the part they might have played in enabling their addict; such as lying for them, giving them money or making excuses for them.
 

Families living with addiction need to be supported through the anxieties and issues they face. They also need an understanding of the treatment process their son, daughter/wife/father/husband/sibling is going through.  Every family is different, so our programme is designed to meet a family’s individual needs. We help them to acknowledge what’s happening in the home, their own behaviours in response and allow them to work out how that impacts the situation for all concerned.
 

Support and assistance in life is critical  – but what about support in death?  For families the problem often becomes worse if the addict/alcoholic dies and I’ll have something to say about that next time.



from Western Counselling https://www.westerncounselling.com/blog/families-and-addiction/dont-forget/
via Alcohol

Wednesday 7 September 2016

Denial of Addiction

Addiction is a powerful, all-consuming disease that has chameleon-like qualities. It can easily take shelter behind other problems in an effort to avoid being recognised.

Addiction has no intention of accepting accountability for the destruction it causes instead, it deflects blame on other people or situations. This is why so many addicts find it impossible to see what everyone around them already knows – addiction has not only taken over their life, it is working diligently to destroy it.

addiction is a disease of denial Western Counselling

For a person struggling with addiction to finally break free, they must first confront their denial. Until they are able to move past denial, there is very little chance they will see the seriousness of the situation for what it really is. Denial is such a common component of addiction, and must be overcome before recovery can begin.

In most cases, addiction slowly progresses, which means that it may be decades before an addict begins to experience the consequences of alcohol  and/ or substance abuse. In fact, it is not unusual for addicts to have positive experiences when actively consuming substances, especially in the beginning; it’s why the use continues and escalates. The truth is that addiction tends to creep up slowly, much like a lion stalking its prey.

Despite the changes, an addict may be experiencing in their mind, body, and overall appearance, he or she is often unaware of what is going on. Instead, their family, friends, and even co-workers will begin to see changes in their appearance and behaviour. This leads to a crucial question- if those around them realise there is a problem, why doesn’t the addict?

For an addict or alcoholic, it tends to be easy to connect happy emotions, memories, and feelings with their drug and/ or alcohol use. In most cases, they view drugs and alcohol as a panacea for the problems and stresses they experience in their everyday life, while the negative components of their addiction are attributed to “bad luck” or something else that is out of their control. They see “using” as a way to celebrate, escape unpleasant feelings or memories, relax after a long day, or numb themselves against emotional or physical pain.

On a subconscious level, they are able to defend their usage simply by denying the reality of their situation. As time progresses, their aspirations, goals, and morals become so low that they begin to see this as normal. When they are confronted by someone who suggests they have a problem, they may become aggressive, angry, withdrawn, or even deflect from the situation. Sadly some may die still holding onto the belief that everything is ok.

Only when an individual truly acknowledges their situation and has honesty and self-awareness about their alcohol and/or drug use, can they possibly start the process of recovery



from Western Counselling https://www.westerncounselling.com/blog/addiction-issues/addiction-denial/
via Alcohol

Sunday 17 July 2016

5 Reasons for Leaving Treatment Early – and how we work to avoid them.

Take me to last weeks article

Deciding on a treatment centre is a big decision; some clients will choose at random others will be methodical in their approach to residential rehab, however despite the preparation, or lack of, there will always be clients who will choose to leave early and not complete their programme.

There are 5 reasons that are commonly given for early discharge from treatment, prior to completion and here’s how we work to re-engage the client in their programme.

  1. “I’m in the wrong rehab” – is a clever justification for leaving.  All family and staff will run themselves ragged trying to find an alternative that is “right” and thereby inadvertently enable and collude in their leaving treatment early.  They deflect their feelings on to the treatment centre and make that the problem not themselves, thereby taking no personal responsibility for the decision – “they would only fund here”, “my mum and dad chose here, not me”, “my care manager said I had to come here”. The food, the environment, other clients, the staff, the location will all be cited as the problem.
    It is really important that we do check out their comments as there may be problems that need resolving and we aim to be flexible to meet the needs of the clients. Staff will recognise when an alternative treatment service needs to be sourced, it’s part of client care.  If we think that actually an alternative service would better meet the client’s needs we will discuss a Treatment Loop with an alternative provider.  What is imperative is that everyone is working together for the best outcome and to keep the individual in treatment and on the recovery pathway.  We believe that families are often fundamental in the decision to leave treatment early, their enabling or colluding can make the difference between a negative or a positive outcome. Maintaining the communication channels and clear boundaries are imperative; The Family Programme can assist families to learn new coping mechanisms to handle difficult situations, develop firm boundaries and support mechanisms.

2. “I’d rather be using” “Detox is too hard” and/or “It wasn’t sooo bad out there!” –  I think we can agree that the first days of a residential treatment programme may be tough – learning the rules, making friends and induction into desperation of addictiona new environment is daunting, especially when you’ve been living in the chaos of active addiction. Undertaking a withdrawal programme of detoxification, having cravings and the fear of life without the crutch of drugs and/or alcohol may be cause for extreme anxiety.
The medication withdrawal must be appropriate to the needs of the individual and their personal drug/alcohol use.  All information is taken into account including substitute prescribing (methadone, subutex), duration of and daily use, their physical and mental health and other prescribed medications.  Induction group helps the individual to assimilate and relaxation techniques and other holistic therapies may be used to ease anxieties; sharing thoughts and feelings can help identification with others and to not feel so alone in the situation. The Medication Liaison Worker will check daily on the individual and discuss how medications affect the emotional and physical stability.  Throughout its really important to us to listen to the individual and ensure their fears are addressed as an important element of their integration.

3. “I’m cured” – Having a strengthened self confidence and improved self esteem is an intended outcome of every treatment service, along with longevity of sobriety of course! However it can be damaging in early treatment to have too much confidence and think they’re invincible, it was never that bad and everything is fine now that detox is completed, the family are re-engaging, a debt management plan has been formulated and they haven’t felt so healthy in years. Now they feel that they manage in the community without additional support and will not consider their vulnerability to relapse.
It is well documented that the longer the individual can be retained in treatment the better, however an attitude of “I know it all” is extremely destructive to both the individual and the therapeutic community.  It demonstrates a lack of humility and that further treatment is required to address issues of ego etc; having said that however, testing out recovery tools can be very useful in helping the individual to recommit to their recovery and we achieve this through transition to other levels of programme intensity, visits and alternative treatment activities, enabling the individual to explore their recovery process with ongoing professional support.

4. “I know all this already” –  Learning through repetition of themes is known to be effective, therefore in addiction treatment there are principles that are repeated and covered in many different ways, continually.  Some individuals discover they require several experiences to fully comprehend a recovery principle and gain the necessary insight. In order to avoid painful memories and feelings being explored, some individuals may choose to use this as an excuse to leave.
Ongoing learning and personal exploration is a recurrent theme throughout treatment and complacency is advised to be strictly avoided, we can always learn more! Through a structured timetable of daily activities, and people attending the service to share their experiences, strength and hope, we help the individual to learn to address their cravings and triggers for relapse. All members of the staff team have client interaction and we all communicate the negative consequences of leaving the programme and taking an early discharge.

5. “I’m different, I’m not like them” – we all need to feel a shared identification whether it be personal, social or professional, it helps us to feel participative and comfortable in a situation. Coming into rehab can be overwhelming, and it is inherent for addicts to feel “different” from anyone else, “special” and even “better” than another.  Emotional barriers are built that maintain these “differences”, that they believe will keep them safe; sadly the truth is that it negatively impacts the effectiveness of the group dynamic and has an adversely affect on outcome.
We ensure that all new clients attend the Induction group together and learn about the process of treatment including detoxification in a less challenging environment than the main therapeutic group sessions. During the Assessment we encourage the individual to meet with the clients and staff and discuss fears and concerns they may be have about residential rehab.  We undertake workshops, lectures and assignments on Denial, Deflection and Justification, that enable the individual to understand they’re rationalising their decision to leave.  Its also important to build trusting and respectful relationships that we work to help everyone identify similarities that may not immediately be apparent, rather than concentrating on the differences.

The video below tells a story of what is possible when an individual completes our full addiction treatment programme.

Visit our YouTube channel for more information about our services.



from Western Counselling http://ift.tt/29NtJII
via Alcohol

Help not hinder, its what makes the world a better place #addictionrecovery #residentialrehab #westerncounselling


via Western Counselling http://ift.tt/29YAesX http://ift.tt/22x2vce

Friday 8 July 2016

Another perspective is often useful....


via Western Counselling http://ift.tt/29qlXSm http://ift.tt/22x2vce

The Realities of Family Life After Rehab

Leaving rehab and returning home can be a stressful time for the everyone in the family, there will be essential changes that need to be faced. Everyone will be seeking to reflect the changes seen in their loved one who have been on an intense journey of self discovery; witnessing these changes and not being on a personal recovery process can lead to feelings of frustration, confusion, anger and feeling left out.  I identify with all these feelings, and when I find myself exhibiting controlling behaviours I recite the Serenity Prayer, remembering to Let Go and Accept The Things I cannot Change.  Its important that all the focus isn’t on the individual newly out of rehab, and that the whole family is reviewing their own part in the family dynamics.

The Serenity Prayer for addiction treatment support

We’ve compiled some do’s and don’ts that may help that transition period for everyone:

1. Enabling

Did you manage and control much of their previous life? Making yourself indispensable in sorting out problems? manipulating situations? Now you need to let them find their own way and manage their own life.  They will have been given the necessary tools whilst in rehab, and now they need to get used to using them and finding their own answers to problems.  Once in recovery it is common for secondary addictive behaviours to emerge including shopping, gambling, sugar, carb loading, and negative obsessional behaviours including male/female attention.  They have the tools, step back and let them find their new path, however difficult it may be to watch.

2. Look After Yourself

This is an emotionally exhausting time and everyone needs to heal ; take some time for yourself and consider whether you need some support or counselling.  Support groups can be wonderful in enabling us to talk openly and express our fears, hopes, anxieties and joys.  Al-anon, DrugFam, NACOA are accessible nationally and internationally and everyone attending will be able to empathise.  Western Counselling delivers a Family Programme every 6-8weeks giving useful information and support on addiction, treatment and recovery.

3. Recovery is personal, don’t interfere

Its important that having left treatment they take responsibility for themselves and the subsequent consequences.  They’ll have meetings to attend and a sponsor to phone and meet, so let them get on with it. If previously you would helped with management of their daily affairs, nows the time to let them get on with it.  Of course you’re going to be concerned and will want to keep checking up on them, checking their movements, interactions with others etc – old habits are hard to break!! However its important that this be discreet and you start to Let Go and let them move forward in confidence.  Reminding them of appointments, meetings etc isn’t allowing them to fully take responsibility for themselves, now’s the time to let them try.

4. Welcome New Roles in your Relationship

During a time of active addiction in a loved one around us we tend to assume “roles”.  There’ll be the caring, loving individual, always there to reassure and take control of everything and make everything all right.  There’ll be the angry individual, expressing their feelings negatively and possibly persecutory; and then there’s often the forgotten one who sits back, presenting as passive with the situation.  Now’s the time for self-awareness, take a look at what’s going on around you and in your relationships, start making some changes and challenging previous personal convictions.  Stop projecting outcomes of a situation or potential conversation and making the necessary preparations for interventions, these assumed outcomes are unlikely to arise and they will further conflict your attitudes. Take this time to develop your own recovery journey and establish coping mechanisms that don’t perpetuate the previous negative patterns.

5. Make Changes

Reflect the change you see in your loved ones, as they start to broaden their horizons now’s the time for you to similarly take some action, consider a new hobby, social activity or other personal opportunity.  Be proactive in the change even if it doesn’t feel comfortable initially. – just think of all the changes the addict has made during their treatment, now you too can make some changes. No longer place their health, happiness and life before your own, assert your boundaries and start living for yourself outside of their needs.

6. Avoid Shame

Living in todays society it can be so easy to deny our situation publically and feel shame and humiliation at whats happening at home.  However, we should be positive about all attempts to get clean and sober and not perpetuate the negativity around us.  Share your feelings in your support meetings or with a private counsellor

7. Never Give up Hope

When you are living in the eternal cycle that is totally addict-centric it can be difficult to see the light at the end of the tunnel. Don’t give up hope, be a consistent reassuring presence.



from Western Counselling http://ift.tt/29zl8tS
via Alcohol